title: Palliative sedation: an essential place for clinical excellence.
abstract: The complexities that converge around palliative sedation invite clinicians to work together to differentiate the issues and come to recommendations and decisions that are humane, ethical, legal, and clinically sound. Whether a crisis or long-term situation exists, the work is essentially the same. It must include critical thinking, clinical expertise, multidimensional assessment, and an array of interventions to assist patients and families in situations where symptoms and suffering are sufficiently intense to warrant exploration of sedation. The many issues inherent in the discussion of sedation at end of life require not that we have the answers but rather that we work with our colleagues to raise relevant questions and integrate both expertise and compassion into end-of-life decisions and care.
authors.affiliation: Palliative Care Service, Dana Farber/Brigham & Women's Cancer Center, 44 Binney Street, SW241B, Boston, MA 02115, USA. phiggins1@parners.org
authors.forename: Philip C
authors.initials: PC
authors.lastname: Higgins
authors.forename: Terry
authors.initials: T
authors.lastname: Altilio
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D016292:Procedural Sedation / Q000941:ethics / Q000379:methods*; D003657:Decision Making; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy* / Q000517:prevention & control; D010166:Palliative Care / Q000941:ethics / Q000379:methods*; D028701:Patient Rights; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D013727:Terminal Care / Q000941:ethics / Q000379:methods*
chemical_list: D006993:Hypnotics and Sedatives